How to add variety to family medicine?

[fullmetal]

I enjoy FM but after working for a while as an attending I think I want to add something beyond regular outpatient office visits at some point in the future.

During residency I enjoyed EM, IM and urgent care. I know that most non-rural hospitals won't hire FM-trained docs for ED doc positions and unfortunately I am stuck living in a major metropolitan area due to my spouse's career. I have heard that they might hire FM-trained docs for the fast track in a major city (maybe). I am not sure if I would need to complete a fellowship in EM to do this. Regarding IM, I am doubtful there would be a hospital that would allow me to take care of my own patient's hospital admissions in a major city. The other option would be to add urgent care.

Does anyone have any sagely advice for someone in my position? Thoughts about working in a fast-track vs. an urgent care clinic?

Thanks.

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[VA Hopeful Dr]

Moonlight in urgent care

 

[Sushirolls]

Here's one idea:

ASCH | American Society of Clinical Hypnosis

www.asch.net

Or if you aren't a DO, go learn some OMM, or if you are a DO brush off the OMM skills.

 

[deleted87716]

Bemoaning a lack of variety in FM likely speaks more to your particular employment situation than the specialty itself.

If you want a lack of variety, by all means try urgent care.

 

[AMEHigh]

Bemoaning a lack of variety in FM likely speaks more to your particular employment situation than the specialty itself.

If you want a lack of variety, by all means try urgent care.

Yeah 100% this!
OP- are you doing procedures? Joint stuff? Skin stuff? Repro health? Etc.
Do you take care of teens? I love my visits with teens, never boring.
Do you have ultrasound availability?
I think the list is endless to having variety in the outpatient setting. Maybe see what’s out there and how you can bring that to your office or find a different job.

But if you don’t want to switch jobs yes urgent care is likely a good place to start. I have a few friends that work in prisons, fast track of ED, 1 day a week of OB call, some nursing home stuff, etc. Those are a few options.

 

[FamilymedMD]

I've added (after many courses) dermoscopy and POCUS.

 

[MedicineZ0Z]

Hospitalist work for sure adds the most true variety.

 

[deleted1025203]

Tough spot. I assume you've trapped yourself in some kind of Kaiser factory medicine type situation and are bored.

First step, would be to get out of that situation. Moonlighting in urgent care would be cool. Hospitalist work is always an option.

Dude, you can't commute an hour or two into the boonies and pull ED shifts?

 

[SLC]

I do a lot of Family Planning Services, LARC contraception etc.

I also do a ton of office procedures.

is there a reason you’re not? Are you referring out your skin biopsies and joint injections etc?

 

[miacomet]

Train yourself in sports. Joint injections, PRP, any kind of non operative ortho stuff. Tell your patients to call you first if they broke this or that- you can cast it or reduce it and bill like crazy for initial fracture care. Learn to reduce shoulders, wrists, (hips not for the office) and what fractures need follow up.

Do school sports physicals, get training in concussion treatment and work with a local PT to treat these cases.

 

[VA Hopeful Dr]

A lot of what you are describing is done at urgent cares (and often done by a lot of PAs). Would agree, sports fellowship is not a bad option for OP but if that's not an ideal option - urgent care is the best option for now.

Unless you're talking about ortho-specific urgent cares, I have never seen nor heard of a midlevel in an urgent care reducing anything and UCs as a general rule will splint things but not cast them.

 

[jm192]

Bemoaning a lack of variety in FM likely speaks more to your particular employment situation than the specialty itself.

If you want a lack of variety, by all means try urgent care.

This.

Urgent care is 40 encounters a day--35 sniffles, a couple rashes, and the occasional medical emergency that somehow wound up in your exam room instead of the ER.

 

[scharnhorst]

what about a Medspa ?

Incorporating "integrative" medicine into your practice ?

 

[VA Hopeful Dr]

what about a Medspa ?

Incorporating "integrative" medicine into your practice ?

Because we're doctors?

 

[scharnhorst]

After some yrs in practice I personally feel if PCPs strive to get really good at treating the top 30 most common medical conditions then there is NO NEED for any additional certifications.
All these other things are distractions , some lucrative some are not.

 

[scharnhorst]

It's a bull**** function but a lot of people who either burn out in medicine/want to make a lot of straight $$ go that route.

Ive seen some people get in trouble too with medspa , its a risky business

 

[FamilymedMD]

Addiction medicine (treated in my office like any other disease) has become one of most satisfying parts of primary care for me.